National Nurses United

My Walkabout I Comparing the American and Australian healthcare systems, how privatization hurts both, and why nurses must fight back. BY DONNA SMITH had been invited to australia by nurses there to share my experiences with the American healthcare system, but ended up learning a lot more about both countries' systems than I ever bargained for. There I was, just two hours after landing in Sydney, safely checked into my hotel room. I was showered and supposed to be resting after my long international flight from Colorado to ease my transition into a new time zone and whole new hemisphere. But I was just too excited. In just two days, I would be speaking to the assembled attendees of the New South Wales Nurses and Midwives' Association conference. As a Medicare for all advocate with Healthcare for All Colorado, a former staffer with National Nurses United, and a casualty of the health insurance industry so well documented in the Michael Moore film SiCKO, NSWNA invited me to Sydney to explain to their members how a privatized healthcare system works (or rather, doesn't work) because corporate forces are so eagerly trying to privatize many parts of Australia's mainly public health system. There would be time to sleep later, I thought. My hotel was in The Rocks section of old Sydney near the Harbour Bridge and famed Sydney Opera House, and I decided to go on a stroll to explore Nurses Walk and some of the old brick streets along the way to the waterfront. Then I fell. It wasn't a simple trip or stumble. It was the worst fall I have ever taken. As I bounced to the pavement first on my artificial knee, then my hip, my forearm and wrist, my shoulder, and finally my cheek, I knew I was sustaining some injuries for which I would likely need medical attention. I was stunned. My arm started bleeding immediately and the area of swelling was growing larger every moment even as I tried to gather myself. My camera, my purse and my small satchel were strewn all over the pavement. I was hurting, shocked, and confused. Within moments, two kind Australian women rushed to help me. One reached for her phone as the other ran into a nearby coffee shop to get wet napkins for my bleeding arm. "I am going to call an ambulance for you," one woman said. And though I wasn't supposed to give my talk for another couple days, that's when my teaching about the perils of privatization, as demonstrated by the dysfunctional U.S. healthcare system, began. 12 N AT I O N A L N U R S E Instantly, even as I lay bleeding and swelling in a heap on the pavement, disoriented by the terrible fall and my jetlagged reflexes, I screamed, "No, please don't call an ambulance! I'm an American!" The woman looked simultaneously confused and hurt, so I pulled myself together enough to give her some context. "I'm sure I'll be all right, and it will be so expensive to call an ambulance. I can't afford it, please don't call." She tried to convince me, but I prevailed. After about 10 minutes, she helped me crawl over to a nearby stairway where I sat for several minutes until I felt like I could gather myself enough to continue with the day. I thanked the women who stopped, told them Americans grow accustomed to not seeking medical help due to the exorbitant costs, even when carrying private health insurance. Even after elevating my arm, cleaning my wound with antiseptic, and keeping ice on the swelling overnight, I was still in tremendous pain. Swelling and bruises were evident in all the other spots I hit when I fell. When the lovely young woman who picked me up to take me to the NSWNMA conference site arrived and saw my injuries, there was no time or point for me to object. The nurses saw to it that I was taken immediately for medical attention to a local clinic with X-ray services. After being thoroughly examined for more than 20 minutes by a physician, having six X-rays done of my wrist and forearm and receiving the radiologist's report, another consultation with the doctor, picking up my prescription for pain relief, and purchasing a special ice pack for travel, the total bill came in: $145. That's right. It was a total of less than $200 for all the services and care I had received, including having the films and reports to take home with me. So, my little accident at the very least allowed me some fact-finding of my own. I knew now that services that would easily have topped $1,500 or more in the United States were $145 in Australia. No wonder the women who stopped to help me were shocked by my reluctance to seek care. They must have thought me nuts. Yes, I realize that an ambulance ride and services in a full emergency room would likely have made that whole experience more expensive and that the sort of cost differential I noted would not be applicable to every area of healthcare services in our two countries, but it was a staggering lesson that provided me with a backdrop to share for the next two weeks as I spoke and was interviewed about the dangers of more privatization of the Australian healthcare system. W W W. N A T I O N A L N U R S E S U N I T E D . O R G DECEMBER 2013

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